LOUDOUN MEDICAL GROUP, P.C. (NPI# 1578002275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578002275 |
| Entity Type | Organization |
| Organization Name | LOUDOUN MEDICAL GROUP, P.C. |
| Other Organization Name | PHYSICIAN PRACTICE AND RESEARCH |
| Practice Address |
19490 Sandridge Way Suite 120 Leesburg VA 20176-3465 |
| Mailing Address |
224d Cornwall St Nw Suite 403 Leesburg VA 20176-2700 |
| Practice Telephone | 7037235555 |
| Practice Fax Number | 7035626996 |
| Mailing Telephone | 7037376001 |
| Mailing Fax Number | 7034438643 |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |
| Authorized Official Name | MARY BETH TAMASY (CEO) |
| Authorized Official Telephone | 7037376012 |
| Is Organization Subpart | Y |
| Parent Organization Name | LOUDOUN MEDICAL GROUP, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Physician Practice and Research | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447760186 | Loudoun Medical Group, P.C. | Obstetrics & Gynecology | 10400 Eaton Pl Ste 430, Fairfax, VA 22030-2208 | 2017-10-09 |
| 1902325608 | Loudoun Medical Group, P.C. | Family Medicine | 224d Cornwall St Nw Ste 102, Leesburg, VA 20176-2700 | 2017-09-13 |
| 1609900208 | Loudoun Medical Group, P.C. | Internal Medicine | 44055 Riverside Pkwy Ste 216, Leesburg, VA 20176-5176 | 2007-03-15 |
| 1427617422 | Loudoun Medical Group, P.C. | Physical Therapist | 19490 Sandridge Way Ste 230, Leesburg, VA 20176-3467 | 2019-06-12 |
| 1386203628 | Loudoun Medical Group, P.C. | Physical Therapist | 6408 Grovedale Dr Ste 102, Alexandria, VA 22310-2596 | 2019-06-11 |
| 1447817689 | Loudoun Medical Group, P.C. | Pathology | 6736 Curran St Ste 1, Mc Lean, VA 22101-3803 | 2019-05-23 |
| 1356907612 | Loudoun Medical Group, P.C. | Clinic/Center | 5901 Kingstowne Village Pkwy Ste 300, Kingstowne, VA 22315-5883 | 2019-05-13 |
| 1295290286 | Loudoun Medical Group, P.C. | Urology | 1860 Town Center Dr Ste 180, Reston, VA 20190-5905 | 2019-02-05 |
| 1346710084 | Loudoun Medical Group, P.C. | Internal Medicine | 24585 Stone Carver Dr Ste 100, Aldie, VA 20105-2798 | 2018-11-26 |
| 1962978569 | Loudoun Medical Group, P.C. | Clinic/Center | 19490 Sandridge Way Ste 240, Leesburg, VA 20176-3467 | 2018-10-22 |
| Street Address |
19490 SANDRIDGE WAY SUITE 120 |
| City | LEESBURG |
| State | VA |
| Zip Code | 20176-3465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790836690 | Jack Pete Ayoub | Obstetrics & Gynecology | 19490 Sandridge Way, 350, Leesburg, VA 20176 | 2007-01-16 |
| 1013457720 | Pure Life Renal of Lansdowne, LLC | Clinic/Center | 19490 Sandridge Way, Suite 140, Leesburg, VA 20176-3465 | 2017-02-28 |
| 1588025027 | Loudoun Medical Group PC | Psychiatry & Neurology | 19490 Sandridge Way, Suite 260, Leesburg, VA 20176-3465 | 2016-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912923 | Timothy Michael Nixon | Pharmacist | 61 Catoctin Circle, Leesburg, VA 20176 | 2020-11-05 |
| 1558996645 | Stacey E Moran | Occupational Therapist | 44124 Woodrige Parkway, Lansdowne, VA 20176 | 2020-03-09 |
| 1710531272 | Joseph H Kasuska Jr. | Specialist/Technologist | 19455 Deerfield Ave. Suite 306, Lansdowne, VA 20176 | 2019-08-01 |
| 1568935849 | Joel Manalang Polintan Jr. | Physical Therapist | 171 Cedarwalk Circle, Leesburg, VA 20176 | 2019-01-09 |
| 1194203026 | Jing Cao | Acupuncturist | 19450 Deerfield Ave Ste 275, Leesburg, VA 20176 | 2018-08-02 |
| 1134648314 | Alaina Marie Gotwalt | Speech-Language Pathologist | 43850 Heatherstone Terrace, Unit 406, Leesburg, VA 20176 | 2017-09-19 |
| 1841717105 | Happy Inhome Care Corp | Respite Care | 722 E Market St Ste 103, Leesburg, VA 20176 | 2017-08-28 |
| 1912423484 | Aaa Good Healthcare LLC | Nursing Care | 722 East Market Street Ne, Suite 102, Leesburg, VA 20176 | 2017-08-16 |
| 1740704253 | Anna Maria Domingo Seaford | Physician Assistant | 19441 Golf Vista Plz Ste 230, Lansdowne, VA 20176 | 2017-07-27 |
| 1710436480 | Reena Patel | Physician Assistant | 224 Cornwall St Nw Leesburg Orthope, Unit 204, Leesburg, VA 20176 | 2016-09-23 |
| Find all providers in zip 20176 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1063967149 | Tri-county Heart Institute Pa | Specialist | 5545 Windsong Oak Dr, Leesburg, FL 34748-7788 | 2016-08-18 |
| 1184093577 | Breast Reconstruction Specialists LLC | Specialist | 224-cornwall Street, Nw, Suite 300, Leesburg, VA 20176-2704 | 2015-09-16 |
| 1649592460 | Allison T. Shorb | Specialist | 217 S King St, Leesburg, VA 20175-2905 | 2010-02-20 |
| 1578899555 | William Barton Mahan | Specialist | 10601 Us Highway 441 Ste E1, Leesburg, FL 34788-7240 | 2009-10-26 |
| 1255527719 | Eze D. Uche, M.d., Pa | Specialist | 4646 Via Del Medico, Leesburg, FL 34748-6995 | 2007-09-19 |
| 1083742571 | Hear Care Inc | Specialist | 1108 W Dixie Ave, Leesburg, FL 34748-6312 | 2007-02-28 |
| 1700958600 | Lake Neurology Clinic, P.a. | Specialist | 608 S 9th Street, Ste A, Leesburg, FL 34748 | 2006-11-15 |
| 1134238140 | Pascual Herrera Jr. | Specialist | 215 Industrial Blouvard, Leesburg, AL 35983 | 2006-08-30 |
| 1578676953 | Alex Marin Uson | Specialist | 1039 W Dixie Ave, Leesburg, FL 34748-6349 | 2006-08-17 |
| Find all providers in LEESBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.